Özofagogastroduodenoskopi uygulanan pediatrik hastalarda biyopsi alınması gerekli midir?

Abstract

Amaç: Son yıllarda çocuklarda özofagogastroduodenoskopi (ÖGD) kullanımı artmaktadır; ancak erişkinlere kıyasla pediatrik yaş grubunda tanısal değeri üzerine yapılan çalışma sayısı sınırlıdır. Bu çalışmanın amacı, çocuklarda ÖGD’nin tanısal değerini değerlendirmek ve endoskopik görünüm normal olsa dahi biyopsi alınmasının önemini ortaya koymaktır.
Gereç ve yöntem: Bu retrospektif çalışmaya, 2015-2022 yılları arasında Sağlık Bilimleri Üniversitesi Antalya Eğitim ve Araştırma Hastanesi Çocuk Gastroenteroloji Kliniği’nde ÖGD yapılan 1-17 yaş aralığında toplam 2295 hasta dahil edilmiştir. Hastaların demografik verileri, klinik özellikleri, endoskopik bulguları ve histopatolojik sonuçları analiz edilmiştir.
Bulgular: En sık başvuru şikâyeti dispepsi (%41,9) idi. Endoskopik bulguları normal olan 762 hastanın 227’sinde (%29,7) histopatolojik anormallik saptandı (bunların 4’ü eozinofilik özofajit idi). Mide endoskopisi normal olan 437 hastanın 346’sında (%79,2) histopatolojik bozukluk görüldü. Duodenumda endoskopik olarak anormallik bulunmayan 1250 hastanın ise 289’unda (%23,1) histopatolojik değişiklik saptandı.
Sonuç: Mukoza endoskopik olarak normal görünse bile anlamlı histopatolojik anormallikler saptanabilmektedir. Bu nedenle, pediatrik ÖGD sırasında alınan biyopsiler, normal görünümlü mukozada bile ek tanısal bilgi sağlayabilir; ancak tüm histolojik anormallikler klinik yönetimi mutlaka değiştirmeyebilir.

Keywords

• Özofagogastroduodenoskopi
• biyopsi
• pediatri

Supporting Institution

Yok

Ethical Statement

Yazarlar herhangi bir çıkar çatışması bulunmadığını beyan ederler. Bu araştırma herhangi bir dış finansman desteği almamıştır.

Is it necessary to take a biopsy in pediatric patients who undergo esophagogastroduodenoscopy

Abstract

Purpose: The use of esophagogastroduodenoscopy (EGD) in children has been increasing in recent years; however, unlike in adults, there are relatively few studies on its diagnostic value in the pediatric population. This study aimed to evaluate the diagnostic yield of EGD in children and to determine the importance of biopsy in cases with normal endoscopic appearance.
Materials and methods: This retrospective study included 2,295 patients aged 1-17 years who underwent EGD at the Pediatric Gastroenterology Clinic of Health Sciences University Antalya Training and Research Hospital between 2015 and 2022. Demographic data, clinical characteristics, endoscopic findings, and histopathological results were analyzed.
Results: The most common presenting complaint was dyspepsia (41.9%). Among 762 patients with normal endoscopic findings, histopathological abnormalities were identified in 227 (29.7%), including 4 cases of eosinophilic esophagitis. In patients without endoscopic abnormalities in the stomach, 346 of 437 (79.2%) had histological abnormalities. Additionally, 289 of 1,250 (23.1%) patients with no duodenal abnormalities endoscopically showed histopathological changes.
Conclusion: Significant histological abnormalities may be detected even when the mucosa appears normal endoscopically. Therefore, biopsies during pediatric EGD may provide additional diagnostic information even in normal-appearing mucosa, although not all histological abnormalities necessarily alter management.

Keywords

• Esophagogastroduodenoscopy
• biopsy
• pediatrics

Supporting Institution

None

Ethical Statement

The authors declare no competing interests. This research received no external funding.

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